Globally, hepatitis B virus (HBV) infections are a major cause of cirrhosis and liver cancer and result in an estimated 620,000 deaths annually. In 1992, the World Health Organization (WHO) set a goal for all countries to introduce hepatitis B (HepB) vaccine into national routine infant immunization programs by 1997. In countries where a high percentage of HBV infections are acquired perinatally (where general population prevalence of chronic HBV infection is >/=8%), WHO recommends administering the first HepB vaccine dose <24 hours after birth to prevent perinatal HBV transmission. To assess implementation of newborn HepB vaccination, the most recently available data were examined from the Joint Reporting Form used by the World Health Organization (WHO) and the United Nations Children's Fund (UNICEF) to track worldwide vaccine coverage for WHO-recommended infant immunizations. In 2006, a total of 162 (84%) of 193 countries had introduced HepB vaccine into their national infant immunization schedules. Among the 193 countries, 81 (42%) reported using a schedule with a HepB vaccine birth dose (defined as a dose administered within 24 hours of birth). Worldwide, 27% of newborns received a HepB vaccine birth dose in 2006. In the 87 countries with >/=8% chronic HBV infection prevalence, HepB vaccine birth dose coverage was 36%. These findings highlight the global need to implement this key hepatitis B prevention strategy more widely.